Hallux valgus — causes, symptoms and extent of injury

Hallux valgus, or lateral flat feet is a common orthopedic disease. Pathology is more common in children and in women after 35 years. Violation of the anatomical structure of the foot is accompanied by the flattening and lowering of the arches. Over time, there is a curvature of the first toe, and changes the posture and gait.

hallux valgus

Briefly about the disease

For hallux valgus curvature characteristic incorrect statement of the stop, in which the support during the walk falls on the inner edge of the sole. Such distortion is always accompanied by X-shaped legs. While the heels moving away from each other by more than 5 cm, and knees touching.

What is deformation? For the normal foot is characterized by almost parallel arrangement of the metatarsal bones. The appearance of transverse flatfoot is a discrepancy in the form of a fan. The base of the big toe deviates medially, and the nail phalanx — little finger.

Head I metatarsal bone is gradually emerging from the articular bed, there is a bone or a lump. Develops Hallux valgus, which literally means "deviation of the first toe".

The disease can be unilateral, bilateral. Most often appears in childhood. Adult patients valgus. arises as a result of many years of running flat or under the influence of external pathogenic factors.

The causes of the disease

Hallux valgus foot can be congenital or acquired. In the first case, the cause of the disease is the disorder of formation of the muscular-ligamentous apparatus in the fetus. It's not unusual for intrauterine effects on unborn baby negative factors: the use of a pregnant woman alcohol, taking medications, experiencing it stress and injury.

To congenital deformation also leads to a genetic predisposition. It is transmitted usually through the female line.

Acquired valgus. is much more reasons. These include pathological aspects:

  • flat feet;
  • foot injuries (bruises, broken toes and metatarsal bones, sprains and tears of tendons, muscles and ligaments of the sole);
  • endocrine diseases (problems with thyroid function, diabetes mellitus);
  • obesity;
  • diseases of the Central nervous system, accompanied by violation of the tone and innervation of the muscles (cerebral palsy, consequences of stroke, spinal injuries, degenerative processes);
  • the connective tissue;
  • rickets.

In older age valgus foot often develops on the background of the presence of flatfoot. At different spinal cord injuries and neurological diseases deformation may appear as a separate pathology.

Most often a flattening of the foot, which is complicated by the deformation of the thumb, is formed in childhood, during pregnancy, at the onset of menopause.

causes of deformation in women

Women halus. valgus. often due to the use of a narrow uncomfortable shoes with high heels. Not immune to the emergence of deformation of the face, often wearing ballet shoes, gym shoes and sports shoes.

In old age bunion begins to grow against the progression of joint diseases: arthritis, arthrosis, bursitis.

How does the disease

Valgus feet is not only a cosmetic defect, but also leads to various functional disorders. The most common symptoms of the disease:

  • discomfort, aching in muscles of foot and lower leg, especially in the evening and during fatigue;
  • the pain in the soles while using shoes with high heels;
  • the deviation of the base of the first finger inside;
  • hesitant, wobbly gait;
  • the curvature and flattening of the foot;
  • redness and abrasions in the area of protruding bone.

In advanced cases, pain concern not only when walking but also at rest.

On examination, the specialist determines the offset of the longitudinal axis of the foot. Its anterior complanatis and taken aside. The patient, standing straight, can't bring your heels together, with knees closely touching. Palpation of the inner edge of the foot painful, the muscles of the soles and calves get pretty tight.

If time does not begin to adequate treatment, all symptoms gradually worsen. Especially quickly the disease develops in adolescence and early adulthood. In elderly patients, the valgus deformity rarely recurs, but there are various functional disorders and the development of associated articular pathology. This is often observed in the postmenopausal period and in obesity.

The degree of development of the disease

In medical practice to distinguish three degrees PLANO-valgus deformity of the foot:

  • easy — arch does not fall below 25 mm, the angle remains in the range of 140°, the apparent curvature of the foot is not;
  • moderate — the height of the vault is reduced to 15 mm, the angle ranges from 141° to 155 mm, there are intermittent signs of joint damage;
  • heavy — the height is reduced to 14 mm and more, the roof angle exceeds 160°, the constant apparent signs of osteoarthritis.

The kids have a valgus deformity can be seen since the start of the walk on the wrong setting foot. If in any doubt on the transverse flat feet need to see a specialist and begin treatment.

Degree halus. valgus. adult patients depend on the angle of deflection of the first finger:

  • I level the warp — the difference between the first and second metatarsals is 12°, and the offset of the first finger does not exceed 20°.
  • II level — abduction angles increased to 17 and 35°, respectively.
  • III level — distance between metatarsals is within 20°, and the first finger is deflected to 45°.
  • Level IV — the angles of divergence exceeds 25 and 45°.

The first and second types of the curvature of the thumb are primarily a cosmetic defect and do not cause the person much discomfort. Much worse with III and IV stage of the disease. When the fingers take the form of hammers, appear non-healing abrasions and blisters. Possible ingrown nail, the development of osteomyelitis.

Therefore, it is important to timely and correct diagnosis of hallux valgus curvature of the foot and the first toe. She will begin treatment in the early stages of the disease and to avoid the unpleasant consequences.

diagnosis of the disease

How to install pathology

Diagnostic measures begin with a thorough inspection of the limbs of the patient. The expert drew attention to the bulging bone and displacement of the big toe compared to the other.
To identify the degree of damage, is assigned to the following additional tests:

  • x-rays of the foot in three planes;
  • computer or magnetic-resonant tomography is necessary to determine the level of curvature and other pathological changes;
  • podometry — helps to estimate the load on the various divisions of a foot;
  • densitometry — determines bone mineral density and risk of osteoporosis.

Sometimes to confirm the diagnosis prescribe ultrasound of the foot, that allows to consider damage to the joints, bones and muscle tendons.

Therapies

Treatment of PLANO-valgus hallux curvature in children should start as early as possible. This will help to avoid worsening of symptoms and the risk to remain flat-footed for life.
For deformity correction prescribe the following conservative methods of influence:

  • physiotherapy;
  • massage;
  • the use of orthopedic footwear and special insoles.

Also widely used therapeutic physical training with individually designed exercise program.

If the curvature of the bones is carried out stepwise correction with the consolidation of the results of plaster cast. After removing the splints prescribed physiotherapy and required to wear a special orthopedic Shoe. Choose shoes, considering the characteristics of the foot and the positive developments that have been achieved during the orthopedic correction.

In adults, conservative treatment is not widely applied. Only 1 and 2 stage of disease possible use of massage and physiotherapy. In advanced cases, the defect is corrected only by surgery.

types of hallux valgus

Other types of foot deformities

In addition to valgus, there are other anatomical abnormalities, most often developing in childhood.

Varus

Pathology of the different kind of foot. Varus foot has the following features:

  • support during the walk falls on the outer edge of the foot;
  • in erectum position, the knees are not closed;
  • gradually, the feet are taking On shape.

A child with this disorder when walking nimis rustice, often stumbles and falls. Varus deviation is most commonly acquired condition. Especially susceptible to the disease of premature, weak and sick rickets children.

To speak of the defect is possible only after 4-5 years. At an earlier age in all children observed physiological flat feet and the wrong position of her feet. Often, the disease develops in young athletes, when the immature muscles and ligaments stop can not withstand high physical loads.

Congenital clubfoot is diagnosed at birth or in the first months of a child's life. Treated this pathology, unlike acquired diseases, long and hard.

Equinovarus

In rare cases, in children, there is Equinovarus or clubfoot as it is popularly called, is the "horse foot". Upon such a violation the patient's foot is turned downwards and inwards. Strain most often occur in kids with cerebral palsy.

Each pathology highlighted by ICD-10 in a separate group with the assignment code. For example, the classic flat foot is encoded as M21.0, Equinovarus deformity is listed at number M21.4, and the congenital clubfoot has code Q66.5.

how to prevent the disease

How to prevent the disease?

Prevention of hallux valgus pathology is in compliance with simple rules. Women should abandon the use uncomfortable and tight shoes with high heels. All people need to control body weight and dosing of physical load.

When the first complaints of pain in the foot and the small curvature of the thumb may need to visit a podiatrist. The specialist will prescribe appropriate treatment that will help prevent disease progression.

In childhood is important to the strengthening of the muscles of the foot. Parents should buy the kid a raised pad for walking and daily workouts stop. Effective swimming and walking barefoot on the sand, small pebbles or grass. So whenever possible, parents should allow the child to run without shoes.

Conclusion

Hallux valgus and first finger is a serious disease. The lack of treatment leads to the development of irreversible violations. So consult a specialist should be promptly and carefully follow all of the recommendations.

05.12.2018